Athletes who are out in cold and wet conditions need to be watchful for frostbite.

Frostbite occurs when tissue actually freezes. Toes are particularly susceptible to this serious condition. Factors that contribute to frostbite include exposure to wind, wet skin (even from sweat), and tight socks and shoes that constrict blood flow.

Early signs of frostbite include numbness, a waxy or pale discoloration of the skin, the tissue becoming firm to the touch, and pain in the area. As the frostbite progresses, the skin gets paler and the pain ceases. Often frostbite will thaw on its own as the person keeps moving or gets into a warm environment and out of the wind, wet, and cold. As the tissue warms, there can be redness, itching, and swelling.

In severe cases of frostbite, the skin becomes immobile as it freezes with underlying tissue. Blisters can form with clear or milky fluid. Blisters filled with blood indicate deeper damage. While the skin may change color, or even darken, do not assume you will lose the toes. It may take weeks or months to know if amputation is necessary. Check with your physician as soon as possible to determine what care is necessary.

Be aware of moisture inside your shoes and socks in extreme cold conditions. Sweat and outside moisture can change to ice inside your socks, leading to frostbite.

Tips for Managing Frostbite

Do not rub your toes to warm them—that causes even more tissue damage.

Do not rub the frostbitten area.

Unless absolutely necessary, don’t walk on frostbitten feet or toes.

Get into a warm environment as soon as possible.

Immerse the affected area in lukewarm—not hot—water, or warm the affected area with the body heat from another person.

Do not use a heating pad, heat lamp, or the heat of a stove, fireplace, or radiator for warming.

Do not rewarm or thaw frostbite unless you are sure you can keep the area warm. It is important to remember that thawing the tissue and then allowing it to refreeze can be devastating. Get professional medical help if possible.